title: Effort-reward imbalance and depression in Japanese medical residents.
abstract: The effort-reward imbalance is an important psychosocial factor which is related to poor health among employees. However, there are few studies that have evaluated effort-reward imbalance among medical residents. The present study was done to determine the association between psychosocial factors at work as defined by the effort-reward imbalance model and depression among Japanese medical residents. We distributed a questionnaire to 227 medical residents at 16 teaching hospitals in Japan at the end of August 2005. We asked participants to answer questions which included demographic information, depressive symptoms, effort-reward imbalance, over-commitment and social support. Depression was evaluated using the Japanese version of the Center for Epidemiologic Studies-Depression (CES-D) scale. The effort-reward imbalance and over-commitment were assessed by the Effort-Reward Imbalance (ERI) questionnaire which Siegrist developed. Social support was determined on a visual analog scale. Logistic regression analysis was performed to determine the associations between effort-reward imbalance and depressive symptoms. Depressive symptoms were found in 35 (29.2%) 1st-year residents and 21 (27.6%) 2nd-year residents. The effort-reward ratio >1 (OR, 8.83; 95% CI, 2.87-27.12) and low social support score (OR, 2.77, 95% CI, 1.36-5.64) were associated with depressive symptoms among medical residents. Effort-reward imbalance was independently related to depression among Japanese medical residents. The present study suggests that balancing between effort and reward at work is important for medical residents' mental health.
authors.affiliation: Department of Occupational Mental Health, Graduate School of Medical Sciences, Kitasato University, Japan. dm05018a@st.kitasato-u.ac.jp
authors.forename: Yumi
authors.initials: Y
authors.lastname: Sakata
authors.forename: Koji
authors.initials: K
authors.lastname: Wada
authors.forename: Akizumi
authors.initials: A
authors.lastname: Tsutsumi
authors.forename: Hiroyasu
authors.initials: H
authors.lastname: Ishikawa
authors.forename: Yutaka
authors.initials: Y
authors.lastname: Aratake
authors.forename: Mayumi
authors.initials: M
authors.lastname: Watanabe
authors.forename: Noritada
authors.initials: N
authors.lastname: Katoh
authors.forename: Yoshiharu
authors.initials: Y
authors.lastname: Aizawa
authors.forename: Katsutoshi
authors.initials: K
authors.lastname: Tanaka
mesh_terms: D000328:Adult; D002055:Burnout, Professional / Q000453:epidemiology / Q000209:etiology*; D003863:Depression / Q000453:epidemiology / Q000209:etiology*; D004501:Education, Medical; D004526:Efficiency; D005260:Female; D006784:Hospitals, Teaching; D006801:Humans; D007396:Internship and Residency; D007564:Japan / Q000453:epidemiology; D016015:Logistic Models; D008297:Male; D008505:Medical Staff, Hospital / Q000523:psychology*; D008511:Medicine / Q000145:classification; D016272:Occupational Health / Q000706:statistics & numerical data*; D010558:Personnel Loyalty; D010561:Personnel Staffing and Scheduling; D011594:Psychometrics / Q000295:instrumentation*; D012201:Reward; D012944:Social Support; D013038:Specialization; D011795:Surveys and Questionnaires; D000078329:Workforce; D016526:Workload / Q000523:psychology*